Photodynamic stimulation device and methods

ABSTRACT

A treatment device which uses a light radiation of multiple wavelengths and pulse-shaped electromagnetic fields for the photodynamic stimulation of cells, especially cells of human tissue, and also for the activation and stimulation of light sensitive substances (PTD). The device produces energy radiation by the use of semiconductor and/or laser diodes, which emit light in several separate wavelengths due to a special operation mode and the use of tuneable diodes. The equipment consists of a stand, with which machine applicators are connected via a jointed arm. The stand is freely moveable on wheels and includes a control mechanism whereby the various parameters for therapy can be adjusted and switched on and off. The stand is also connected to a hand applicator for treatment of small tissue-areas, e.g., acupuncture points. Photodynamic substances are introduced into the tissue with a special hand applicator.

PRIORITY CLAIM

This is a U.S. national stage of application No. PCT/NO02/00033, filedon Jan. 22, 2002. Priority is claimed on that application and on thefollowing application(s): Country: Norway, Application No.: 20010373,Filed: Jan. 22, 2001.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates in general to electrotherapy devices andmore particularly to devices and methods for photodynamic andelectromagnetic stimulation of living tissue, directly and alsoindirectly, by stimulation of photosensitive substances introduced intoor onto living tissue.

2. Description of Related Science

The mitochondria within the cells of protozoa and metazoa are sources ofenergy produced by cell respiration. They are moreover capable ofsynthesizing proteins, because they have a genetic system of DNA and RNAindependent of the cell nucleus.

The mitochondrias' main function, however, is vesicular respiration.This is the transformation within the cells of nutrients and oxygen(supplied, amongst other ways, via the bloodstream) into energy andendogenous substances, whereby through this transformation, wasteproducts like water, carbon dioxide, alcohol and lactic acid areproduced. Of great importance is adenosine-triphosphoric acid (ATP),which is synthesized by the mitochondria into adenosinediphosphoric acid(ADP) and orthophosphate. Complicated chemical compounds are of greatimportance as reaction catalysts.

Stimulation of the vesicular respiration, especially a stimulation ofthe ATP production by cells, is used therapeutically to meet strongdemands on cell energy during healing processes, and forweight-reduction, wound-healing and reduction of pain sensitivity due toillness or weakness caused by hypo- or depolarization of the cellmembrane. In general, weakening of cells caused by an increase ofvesicular respiration due to stress, illness or by old age can becounteracted. In order to achieve stimulation of the mitochondriathrough optical radiation, two conditions must be fulfilled. Theradiation must be of appropriate wavelengths in order to be effective,and a pulse frequency must be chosen to penetrate to an appropriatetissue depth without causing tissue damage or pain.

Moreover, pulsating electromagnetic fields have been shown to exert apositive influence on the bodies of both animals and humans. With thehelp of pulsating electromagnetic fields it is possible to send protonsfrom electrolytic internal body fluids such as blood or lymph directlyand in controlled measures into the surrounding vessel walls andmembranes. This is normally not possible, since the lipids in themembranes of the blood vessel walls, which are in contact with theblood, carry a negative charge creating a surface potential whichhinders the protons and ions from entering the vessel walls. Thepulsating electromagnetic field enables the protons to enter the celland vessel walls in spite of the barrier. When this occurs, theincreased concentration of protons within the cell and vessel wallsreverses the polarity of the barrier, thereby hindering the protons andions from exiting through the cell and vessel walls again. In turn, thisphenomenon causes a beneficial change in the local pH value, especiallywithin the vessel walls. Additionally, prolonged exposure to pulsatingelectromagnetic fields has other effects, such as the electricalconstriction of the membranes and vessel walls, the adjustment ofpolyvalent ion chains, the tangential displacement of absorbed counterions, the force effect on dielectric bodies in homogeneous andnon-homogenous fields, and electro-osmosis.

A device is known (Patent DE-U-8-13852/Normed, E. Larsen). which usesinfrared radiation for the photodynamic stimulation of energy in livingcells, cells at the surface of the skin and especially cells lyingdeeper down. The device consists of a supply and control mechanism andan applicator on which infrared radiating (from 900 nm [1 nm=1nanometer]) semiconductor diodes are mounted with reflectors for thebundling of the IR radiation from the applicator (IR=infrared). In thisknown device, a generator containing a control-mechanism supplies thesemiconductor diodes with current pulses of a frequency within the rangeof 500-5000 Hz. A disadvantage of the known device is that thesemiconductor diodes tend to overheat during use, which causes adecrease in the effectiveness of the device.

The known device therefore does not deliver a constant effect duringuse. Another disadvantage is that only infrared radiation within a rangeof 900 nm is available, while other wavelengths may be called for toachieve cell stimulation.

Another device (Patent EPA 0568 666) is used for the photodynamicstimulation of cells. The semiconductor and/or laser diodes radiatelight of different wavelengths. With the aid of light sensors theadvanced control-system is able to test the patients for the requiredradiation dose in order to avoid over-stimulation. Furthermore, theradiation outlets in the applicators are covered with a polarizationfilter, which enhances absorption in the irradiated tissue. The basicequipment consists of a mobile stand, to which machine applicators areconnected with a jointed arm. The machine applicators are adapted forthe treatment of large tissue-areas, for example the back of humans. Thedevice also includes a control-mechanism, whereby the various parametersfor therapy can be adjusted and switched ON and OFF. The device is alsoconnected to a hand applicator designed for the treatment of smalltissue-areas, e.g. acupuncture points or dental treatment with the aidof a connectable fibre.

Another device is (EPA Patent 0570 544), which uses electromagneticfields for therapy on humans and animals. The pulse-shapedelectromagnetic fields cause protons to migrate out of the electrolyticinternal body fluids into the surrounding vessel walls and membranes.The device produces the electromagnetic pulse-bundles in a certainpulse-rhythm, in which each pulse-bundle is followed by a pause. Thebasic device consists of a generator for producing the electro-magneticpulses, connected with a transmitter coil, whose windings are placed onthe surface of the base plate. The base plates are manufactured fromlight, flexible insulating material and mounted in a flat applicatorhousing placed on a jointed arm connected to the basic device.

In the fields of dermatology and rehabilitation, light is used as astand-alone therapy for wounds, leg ulcers, eczema, burns, pain,rheumatic disorders etc., and as such is used to stimulate tissuedirectly. Techniques are known for introducing agents for altering thelight absorbing qualities of tissue to enhance the effect of light (forexample, U.S. Pat. No. 5,226,907 to Tankovich teaches contamination ofhair follicles with a dark particulate material to enhance light-inducedheating in the follicles for hair removal).

Treatments have included the application of substances such asphotoflim, 5-aminolevulan acid, hematoporphyrin, verteporfin, chlorins,phthalodyanines, phenothiazine, and benzoporphyrin-derivative monoacid-A(ATMPn) onto or into tissue for healing solar keratoses, basal cellcarcinoma, melanomas, etc. Such substances are known as“biopharmaceuticals” and treatment with these substances has been calledbiopharmaceutical therapy. Therapy involving the application ofbiopharmaceuticals and their subsequent activation by light after theyhave been absorbed into tissue has been called photodynamic therapy(PDT).

PDT has been used successfully in the treatment of internal inoperablecancers. A biopharmaceutical (specifically, hematoporphyrin) is injectedinto the tumor tissue, and an optical method known as photodynamicdiagnosis (PD) is used to determine when the biopharmaceutical has beenabsorbed by the entire tumor. Then the tumor tissue is irradiated withlight typical for a dye laser, which activates the photosensitivereactors in the hematoporphyrin, whereby singlet oxygen is liberated.Singlet oxygen is toxic to protein and phosphorlipids in the tumortissue, whereby the tumor is destroyed without destroying thesurrounding tissue.

For treatment of skin keratosis (pre-cancerous tissue), trials with, forexample, 5-aminolevulinic acid have shown that it can be usedeffectively in PDT if introduced into oil in a water suspension which isthen applied to skin keratosis and then irradiated with a light source.A fast and cosmetically perfect healing has been attained with a verylow rate of recurrence compared to conventional treatments, such ascryo-therapy. In view of these favourable test results, it isanticipated that pharmaceutical companies will be marketing the nextgenerations of PDT chemicals in convenient forms, such as creams,suspensions, sprays, etc.

The light source typically used to irradiate PDT chemicals is commonlyknown as the surgical laser, a solid-state laser which is bulky, andwhich is expensive both to purchase and to operate. Surgical lasers aredesigned primarily for cutting, i.e., they output very high energy in avery small spot, and are thus difficult to adapt to the requirements ofirradiating a more generalized area for PDT. Further, they generallyradiate at a single wavelength Radiation at several wavelengths isdesirable in PDT, for several reasons: a single wavelength may cause thepatient to experience burning pain in adjacent tissue during treatment;some photosensitive chemicals respond to two different wavelengths; and,some pigmented melanomas do not respond to visible radiation due toabsorption in the pigment (typically melanin), and must be irradiatedwith near-infrared light.

Common dermatological diseases like acne, warts, and onychomycosis (nailfungus) can successfully be treated with light as a stand-alonetreatment, but recent work indicates that treatments using PDT (withALA/5-aminolevulanic acid) give excellent results with only two or threetreatments.

In a recent pilot study using PDT to treat acne, the cosmetic resultswere excellent, and oil gland activity which causes acne, and theresultant inflammation, were reduced for as much as twenty weeks after aseries of PDT treatments. (The PDT treatments precipitated immediate butshort-term inflammatory reactions.) In general the photodynamicstimulation used in physiotherapy is producing very good results, but inthe area of long-term chronic diseases such as gout, arthritis, etc.there is often a need for many treatments, as many as 12-20 treatmentsspaced over a period of time. Also, initial phases of such treatmentoften cause reactions, which in turn cause pain and discomfort. A recenttrial study showed that using a light and/or laser radiation combinedwith an electromagnetic field emission resulted in better results,without reactions to the intensive therapy. It seems that the combinedradiation has a better penetration due to the electromagnetic fieldsremoving the blocking potential and the vasodilatation of thecapillaries, whereby the increased ATP energy is better utilized.

A recent trial in post-surgery light and/or laser therapy after coronaryangioplasty and stenting, where the restenosis rate is normally quitehigh, showed promising results, and here again it is expected that theresults can be improved using a light sensitive biopharmaceutical forregeneration and stabilisation of the vessel walls.

Studies also support the theory that a light and/or laser radiation ofblood can provide an effective therapy for chronic diseases such asleukemia and cancer, our tests on athletes also support the theory thatthis therapy improves the immune system and the vitality.

A number of erothrocytes are often damaged in artificial heart-lungmachines, but blood irradiated with light and/or laser showed lessdeformability and the ATP levels were significantly higher. Here too weexpect an increased activity of the leukocytes and and lymfocytes byusing light sensitive biopharmaceuticals.

For many years large-surface therapy systems for dermatological diseaseslike psoriasis have been equipped with UV radiation sources, for exampleUV tubes. Prior to the treatment the patients have received varioustypes of photo-chemical substances like 8-MOP (Oxsoralen), 5-MOP orMeladinine (bathing therapy). Due to the risk of skin cancer and otherside effects the use of PUVA therapy has declined during recent years.When more studies have been completed it is expected that PDT will infuture be the procedure of choice for treating most chronicdermatological diseases, due to its effectiveness and lack of sideeffects.

Also due to the risk of skin cancer, tanning on sun-beds has declinedmuch during recent years. Among other side effects is the erythema thatfollows the first treatments, and most patients, especially those withfair skin, find that their skin becomes very dry and irritated.

Our tests have showed that by using a combination of UV light andphotodynamic light produced by semiconductor diodes, we can avoid allthe side effects of using sun-beds. It is also expected that theincreased vitality (high ATP level) of the skin can counteract the riskof skin cancer.

In classical acupuncture a technique called moxibustion is commonly usedfor the treatment of deep-lying acupuncture points, especially inchronic diseases. Needles with a special metal handle are used and,after the needles are inserted in the patient, a herbal substance isplaced on the handle and combusted, whereby the needle is heated andleads the heat deep into the tissues. The effect is excellent, butwestern doctors do not like this praxis because of the strong smell,which may linger for several days.

This method can now be replaced by the application of topicallight-sensitive lotions over the acupuncture points, which aresubsequently radiated with a suitable light and/or laser radiation.Looking at the current state of technology, devices are available forthe photodynamic stimulation of human cell energy in the form of red andinfrared radiation emitted by laser diodes and semiconductor diodes.These devices are not suitable for intensive, invasive and whole bodytreatments mainly due to the lack of applicators with suitableadjustable radiation sources for fill surface treatment with combineddiagnostic abilities during treatment. The same can be said for existingdevices for treatment with pulsating electromagnetic fields. Moreover, acombined treatment with both red/infrared and blue light together withelectromagnetic fields is not possible with these devices for thestimulation of light sensitive substances.

A device able to deliver an intensive light radiation with selectivemultiple wavelengths within the wavelength area of 300-2000 nm andelectromagnetic fields is not at present available. Thus the inventionis aimed at creating a device for intensive photodynamic therapy, whichis capable of stimulating photodynamic energy of selective multiplelight and/or laser radiation within a wavelength range of 300-2000nanometers, capable of treatment with pulsating electromagnetic fields,and can also be used for stimulating light sensitive biopharmaceuticals.

SUMMARY OF THE INVENTION

The present invention provides a device with changeable applicatorsusing a light and/or laser radiation of several wavelength ranges suitedfor the photodynamic stimulation of the cell energy in living cells, inparticular human cells of both surface and underlying tissue. The lightand/or laser radiation especially enhances vesicular respiration, mostparticularly stimulation of the ATP production in cells, thus increasingthe therapeutic capabilities of the device. Furthermore, it is alsopossible to stimulate the activity of the cytochromes and the enzymeactivity of the cells.

The device consists of a stand, to which machine applicators areconnected by means of a jointed arm. The stand, freely moveable onwheels, consists of a control mechanism, on which the desired therapydata can be adjusted and the device can be switched ON and OFF. Theplain surface applicators can consist of several applicators placed sideby side and flexibly connected with each other through hinges, wherebythe applicators are suitable for the treatment of large-area tissuessuch as the human back.

The applicators contain printed circuit boards mounted withsemiconductor diodes and/or laser diodes (in large numbers), and thediodes are mounted with reflectors, which collect the radiation andbundle them in front of the applicator. The applicators also contain oneor more transmitter coils for the emission of pulse-shapedelectromagnetic radiation. The applicators are also equipped with anadjustable scan system, which permits an even and gap-free radiation ofthe surface with the multiple wavelengths of light.

A diagnostic system (PD) containing a fluorescent light source andoptics for photodiagnosis during the treatment is also included in theapplicator.

At least one of the applicator elements is equipped with feedbacksensors for controlling the patient's response to the therapy, and viaan automatic regulation system in the control mechanism it is possibleto optimise the therapy results. The applicator contains a polarizationfilter, which is placed directly in front of the diodes. The controlmechanism is also connected with a hand applicator, which is constructedfor treatment of small tissue areas, e.g. acupuncture points and triggerpoints (pain points).

The hand applicator includes a cylindrical shaft to which a headpiece isconnected. A printed circuit board is fastened to the headpiece, mountedwith semiconductor diodes or laser diodes. The light radiation isemitted from an axial opening in the front, equipped with a polarizationfilter and a lens for the focusing of the light rays.

A second version hand applicator, which is especially invented fordental and/or invasive treatment, including (PD) diagnosis, contains atthe front end of its shaft a printed circuit board, where 4 light and/orlaser diodes of different wavelengths are placed at 90° intervals. Oneof these radiation sources can be selected as a fluorescent light fordiagnostic purposes (PD) related to PDT therapy using light reactivebiopharmaceuticals. The headpiece in front of the printed circuit boardcan be rotated in steps of 90° so that the expander, which isconnectable with various types of optical fibres, can be positioned infront of either radiation source. The applicator may selectively emitblue light for the bonding and hardening of composite plastic fillingsor infrared light for the treatment of dental pain, gingivitis, andwounds. In order to optimise bonding with the blue light, the output ofthe hand applicator is supplied at 25% of full power for the first tenseconds of the radiation time, and then is switched to full power.

Acupuncture applicators made as small heads mounted on self-adhesivepads connected to the control mechanism, allow a certain number ofapplicators to be connected corresponding with the usual number ofpoints utilised in classical acupuncture. The control mechanism can beprogrammed for a randomised acupuncture programme with changingfrequency, modulation and amplitude instead of a programme withclassical needling and Moxa treatment.

Two applicator types are made for the stimulation of blood, either ofvenous blood or integrated in a heart/lung-machine. The first applicatorallows radiation of blood passing the applicators' radiation sources ina 5 mm infusion lead, and the second version provides an intensiveradiation of a quadrant tube, where the blood passes and receivesradiation from 4 sides from light and/or laser diodes mounted onprint-boards also containing transmitter coils radiating pulse-shapedelectromagnetic emission.

The applicators can also be designed as standard 2 meter and 15 cm longlight tubes of the type commonly used in sun-beds for whole bodytherapy. Here it is advantageous to make the applicator in the form of aflat oval tube in order to achieve a better radiation surface. The tubeapplicators contain print-boards mounted with a suitable number ofsemiconductor light and/or laser-diodes as well as transmitter coils forthe emission of pulse-shaped electromagnetic fields. The applicators arethen mounted in a large body treatment arrangement like a sun-bed, wherethe patient lies on the lower part beneath a top part covering the wholebody. Applicators of this type could be useful for treating officeworkers suffering from SAD disorders caused by too little exposure tonatural light.

The invention provides multiple wavelength stimulation that is alsoeffective in conjunction with photodynamic therapy (PDT) chemicals. Suchchemicals are applied or injected into or onto tissue to be treated, andsubsequent photo-stimulation of them causes reactions in them thatresult in treatment of the tissue. Irradiation at multiple wavelengthsenhances the effects of PDT chemicals while reducing discomfort to thepatient.

The present invention provides an apparatus including a semiconductorlight source including a hand applicator. The hand applicator canselectively emit light of various wavelengths and introduce thelight-sensitive substances into the tissue by means of air-pressure andelectrical impulses (iontophoresis). The absorption time, depending onthe type of light-reactive substances, may vary from 1 to 24 hourswithout this technique. Other advantages with the described techniqueare that the light-sensitive substances can be applied very preciselyand the absorption dose can be improved and more accurately regulated.

Other advantages of the invention will become evident from the followingdescription of the invention and from the appended drawings, wherein:

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective drawing of the invented device,

FIGS. 2 a, 2 b, 2 c, 2 d illustrate details of the machine applicator ofthe invented device;

FIG. 3 illustrates a jointed arm used for the movable connection of themachine applicators;

FIG. 4 is a circuit block diagram of a control unit, which supplies theapplicators.

FIG. 5 depicts a hand applicator according to the present invention;

FIG. 6 depicts a schematic representation of an applicator conforming toFIG. 5 with axial light emission;

FIG. 6 a depicts a cross section of the hand applicator of FIG. 5;

FIG. 7 depicts a schematic representation of the light sources with asensor of FIG. 6;

FIG. 7 a depicts a cross-section of the light sources of the handapplicator of FIG. 5;

FIG. 8 an applicator with a rotary headpiece;

FIG. 9. shows details of a printed circuit board for the applicator ofFIG. 8; and

FIG. 10 depicts the flexible light fibre cable with adaptor,

FIG. 11 shows the air unit with the hand applicator belonging to thispart of the invention.

FIG. 12 illustrates an exchangeable round head for the hand applicator.

FIG. 13 a shows the hand applicator for light-sensitive substancesviewed from below.

FIG. 13 b illustrates the hand applicator in side view.

FIG. 14 a shows the acupuncture applicator in top view,

FIG. 14 b depicts the acupuncture applicator from the underside, showingthe light sources.

FIG. 15 a illustrates a rectangular hand-applicator in a top view;

FIG. 15 b shows the hand applicator in side view with skin contact usedfor hair removal;

FIG. 15 c illustrates the hand applicator viewed from below, showing thelight sources;

FIG. 16 a illustrates a tube applicator for the radiation of blood;

FIG. 16 b shows the applicator-like quadratic tube viewed from the end;

FIG. 16 c shows the quadratic tube used for blood radiation;

FIG. 17 a shows the body applicator viewed from the end, in closed mode;

FIG. 17 b shows the body applicator open, with the radiation surface ofthe lower and upper part;

FIG. 17 c illustrates the closed body applicator in a side view.

FIG. 18 a illustrates a round light tube as seen from above;

FIG. 18 b illustrates the round light tube viewed from the end;

FIG. 18 c shows the light tube formed as a flat oval and viewed fromabove;

FIG. 18 d shows the flat oval light tube viewed from the end;

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

As shown in FIG. 1, the invented device 10 for the stimulation of cellswith the aid of (PDT) photodynamic light and electromagnetic fieldscombined with light sensitive substances consists of a stand 11, withwhich machine applicators 13 (in the following just called applicators13) are connected through a jointed arm 12. The stand 11 is alsoconnected by an electric circuit 14 with a hand applicator 15. The stand11, freely movable on wheels, includes control mechanism 16 (describedin FIG. 4), whereby the function of the control mechanism 16 can beadjusted and switched ON/OFF at a control panel 30 (also calleddescription equipment 30).

The FIGS. 2 a, 2 b and 2 c show plain surfaced printed circuit boardswith light sources mounted in the applicators 13. These can be used inthe working model according to FIG. 2 a to 2 c individually, side byside (in large numbers) or in combination with an applicator.Furthermore the printed circuit boards on which the light sources aremounted can favourably be produced as multilayer, also containing theelectromagnetic field transmitter coils 65 shown in FIG. 2 d. Accordingto FIG. 2 a, the applicators 13 in the working model are mounted in ashifting order with semiconductor diodes (LED) and/or laser diodes 17and 17 a Cm the following called light sources), whereby shifting theorder of the light sources 17 means, that the respective light source 17a of one row is placed at the point of intersection of the two diagonalsthrough the two respective light sources 17, which are placed adjoiningon both sides. The light sources 17 and 17 a are mounted with reflectors18, which collect the radiation and bundle it in front of the applicator13. The applicator contains a polarization filter, which is placeddirectly in front of the light sources 17 and 17 a, whereby theradiation can be better absorbed by the irradiated tissue.

According to FIGS. 2 b and 2 c the light sources 17 are placed inregular row arrangements, i.e., 20 equidistant from each other, whereby,according to FIG. 2 c, one applicator 13, in addition to the diodes 17,has a light source 19. The light sources 17 are adjustable and canradiate light in at least three wavelengths within the wavelength area300-2000 nm. The light source 19 formed as a tube can be selected forradiating blue light or fluorescent light within the wavelength area of300-450 nm for photodiagnostics (PD). A diagnostic system (PD)containing optics 67 with a magnifier for photodiagnosis during the thetreatment is also included in the applicator. The light sources 17 a(FIG. 2 a) radiate light with a wavelength of 350-500 nm, i.e., bluelight.

For the treatment of large-area tissues according to FIG. 1, severalapplicators 13 are flexibly connected to each other through hinges 10,respectively connecting one edge with the other, whereby the applicatorsare suitable for the treatment of for example, the backs of humans andso become adjustable for an equidistant positioning of the applicators13 above the skin. In each applicator the printed circuit board carryingthe light sources is connected to a small electrical scan engine 66,which can move the light sources with linear movements, whereby acorrectly adjusted scan length and frequency gives the radiated surfacea total radiation at the necessary wavelengths without leaving anyunradiated gaps.

The jointed arm 12, shown in FIG. 3, connects one or more applicator(s)13 with the stand 11. The jointed arm 12 has three joint carriers21,22,23, where the joint carrier 21, together with the stand 11 and thejoint carrier 23 are moveable at a free end through a fixing joint 24connected with one or more applicators 13. Another fixing joint 25connects the joint carrier 23 with 21, while the joint carrier 22 isconnected with the joint carrier 21 with a hinge 26. The joint carrier21 is connected with the stand 11 through a joint 27 and one or morejoints can also be produced as friction-adjustable ball-joints, whichgives almost unlimited adjustment possibilities and user comfort. Thejointed arm 12 thereby allows the positioning of the applicators 13 infront of, or above, a tissue area while maintaining a correctpositioning distance. The jointed arm 12 also carries the electricalcircuits 14 (not further described) from the control mechanism 16, whichis integrated in stand 11, to the applicator(s) 13.

According to FIG. 4 the controller mechanism 16 consists of a generator28, a timer 29, and a display 30. With help of the generator 28 thecurrent pulses necessary to the production of light and the currentpulses for the supply to the transmitter coils emitting theelectromagnetic fields are contributed, while with the aid of timer 29,all time functions are adjustable, e.g. the duration of treatment.Display 30 shows pertinent treatment data, such as current pulsefrequency, pulse length, pulse amplitude and pulse modulation. With thehelp of the control mechanism 16, the invented device is adjustablewithin a relatively large range with reference to duration, amplitudeand frequency of surge of current, so that the light sources, such assemiconductor diodes or laser diodes can be used.

For that purpose the control mechanism is equipped with a switch selectsystem for operating different types of light sources 17, 17 a, i.e.semiconductor diodes and/or laser diodes. Both semiconductor diodesand/or laser diodes with tuneable wavelengths can be operated, which isa great advantage, and therefore the printed circuit boards can beequipped with a more intensive radiation effect.

The semiconductor diodes and laser diodes are tuneable in wavelength bymeans of various methods such as resonators, piezo elements or by thehelp of special current modes.

The semiconductor diodes and/or laser diodes useable in this inventionemit a light radiation with either SPE (single photon emission), TPE(Two photon emission) and/or MTE (multiple photon emission) within thewavelength area of 300-2000 nanometers in order to correspond withavailable light sensitive substances (PDT).

The useable light sources in the form of semiconductor diodes and/orlaser diodes are supplied with current pulse lengths of ms, ns and/or fs(femto-seconds) within a frequency range of 1 KHz-100 MHz.

The transmitter coil (transducer) for transmitting the pulse-shapedelectromagnetic fields is supplied with basic pulses having a frequencybetween 2 and 500 Hz; ON times of about four-tenths of a period; OFFtimes of about six-tenths of a period and non-instantaneous rise andfill times. Furthermore, the basic pulses can be superimposed withpulse-bundles at a frequency off about 10 KHz and, optionally, also withpulse-bundles of a frequency between 20-30 MHz.

The applicators 13, according to the FIGS. 2 a, 2 b and 2 c are equippedwith sensors 32 arranged between the semiconductor and/or laser diodes17. For therapeutic uses it is typically intended to apply a givenamount of energy (Joule/cm2) per irradiated surface of tissue, which canbe adjusted at the control mechanism 16. Sensors 32 measure the amountof energy radiated away from the skin surface, which is indicative ofthe total energy penetrating into the tissue. Taking into accountindividual variations from patient to patient, the exposure can bedetermined according to the measurements taken by the sensors 32 so thatthe correct amount of therapeutic energy (Joule/cm2) reaches the tissue.An increase of the registered amount of energy can be achieved by theinvented device by increasing the operating potential (and thereby thepulse amplitude) or the pulse frequency and/or prolonging the durationof the treatment time through an adjustment of the control mechanism 16.

A sensor 32 a is also contained in at least one of the machineapplicators, measuring the temperature change of the radiated tissue,whereby the control unit can react with a feedback regulation of theradiation parameters depending on the therapy indication, location and(PDT) light sensitive substance used.

While the applicators 13 according to FIGS. 2 a, 2 b and 2 c areconstructed for the treatment of larger tissue areas, the handapplicators 15 a, 15 b according to FIGS. 5 and 8 are constructed forthe treatment of small tissue areas.

The hand applicator 15 a includes a cylindrical shaft 34, with a handleto which a headpiece 35 is connected. At the headpiece 35 a printedcircuit board 36 is fastened with light sources 17 of tuneablewavelengths (not described). In headpiece 35, in front of the opening39, are placed a lens 40 for the focusing of the light rays and apolarization filter 41. The device with this kind of light 38 emissionis especially designed for the treatment of small tissue areas, e.g.acupuncture points and triggerpoints.

FIG. 8, in connection with FIG. 9, describes a hand applicator 15 b,which is especially intended for dental treatment and internal medicaltreatment. The applicator 15 b shows at the front end of the shaft 42 aprinted circuit board 43, where three different light sources 44 withtuneable wavelengths within the wavelength area of 300-2000 nm and alight source 45 for photodiagnostics (PD) are placed. In front of theprinted circuit board 43 a headpiece 46 is placed, connected with aninterchangeable fastened hollow expander 47, in which an optical fibreis sealed (not shown). The head piece 46 is in front of the printedcircuit board 43 so it can be rotated 360° in steps of 90°, so that theexpander 47 can be positioned in front of either one of the three lightsources 44 a, 44 b, 44 c, depending on the required wavelength fortherapy, or in front of the light source 45 if fluorescent light forphotodiagnostics (PD) is needed. If the expander 47 is positioned, forexample, in front of the diode 44 b, light within the infraredwavelength area is transmitted through the optical fibre in expander 47and ultimately strikes the tissue, e.g. gum tissue, through whichpainful gingival diseases can be treated. Through a positioning of theexpander 47 in front of the 44 a, blue light with a wavelength of 470 nmis conducted through the expander 47, with which plastic fillings inteeth can be hardened. It is obvious that the light rays with this formof execution can also be conducted through polarization fibres.Furthermore, the two hand applicators are equipped with sensors 32 forthe same purpose as described for the applicators 13. The handapplicator 15 b can also be very useful in the case of internal medicaldiseases, where the flexible fibre cable can be used together with avideo-cable, which is produced with an internal opening forinstrumentation, laser fibre etc. In this situation the flexible lightfibre cable is connected, whereby first the light source 45 is used forphotodiagnosis and hereafter one of the light sources 44 a, 44 b, 44 cis selected for the treatment.

FIG. 11 Shows a diagram of the air-pressure unit 48, which can either bebuilt into the control mechanism of the device or produced as a separatedevice connectable with the invented photodynamic stimulation device.The air unit can either be produced as a rechargeable air-tank or as asmall air-compressor with container. The container outlet is equippedwith a reduction valve 51, combined with a pressure meter 52, offamiliar sort. The electronic valve 51 a in the air tube 49 leading tothe hand applicator 50 can be switched on from the hand applicator andthe ON impulses can be regulated at the control mechanism 53. Thecurrent impulses 63 and amplitude 64 for the iontophoresis treatment arealso adjustable at the control mechanism.

FIG. 12 illustrates an interchangeable round head 56 for the handapplicator, which can be changed via a click in bracket (notillustrated). The treatment head 56 is interchangeable according to thepurpose of radiation, so that a round head could be used for treatinground spots, while a rectangular head 56 a would be preferable fortreating wrinkles.

In FIG. 13 a the hand applicator is illustrated seen from below, mountedwith a rectangular treatment head 56 a. Next to the treatment head thelight sources 17, 17 a are placed in rows covered by a polarizationfilter 37 and/or lens system. A sensor 32 for feedback measurement isalso integrated.

FIG. 13 b shows a drawing of the hand applicator 50, which can be usedfor the following purposes:

-   -   Introducing light-reactive substances to the tissue with the aid        of air-pressure pulses    -   Introducing light-reactive substances to the tissue with the aid        of iontophoresis    -   Radiating the tissue with a mixture of light radiation, which        can be selected on the control mechanism.

The hand applicator contains a valve 55 placed just after the air inlet,prohibiting the substances from running back into the air tube 49. Thetreatment head is mounted with a sensor 57 permitting exposure only onskin contact and furthermore the head also contains a valve-system 58,which opens only on skin contact, thus preventing the substances fromrunning out of the head before it touches the skin.

The chamber 59 containing the substances is placed next to the air ductin the hand applicator 50 and the chamber is connected with a dosagepump 60, so that the amount of substance per air-shot can be dosed veryaccurately.

The hand applicator 50 housing is made of an insulating material, andthe treatment head 56 is made of an electrically conductive material sothat it can also be used for iontophoresis treatment combined withair-pressure treatment in order to attain maximum absorption.

Around the treatment head the light sources 17, 17 a, are placed for theselective light radiation.

The ON/OFF switches 54, 61, 62 for operating the hand applicator areplaced on the top of the applicator. During the iontophoresis treatmentthe patient must hold an electric conductor 65 handle in his hand.

FIG. 14 a illustrates an acupuncture applicator made with a small headcontaining the light sources mounted on a self-adhesive pad connected tothe control mechanism, which allows a certain number of applicators tobe connected corresponding with the usual number of needles used in aclassical acupuncture treatment. FIG. 14 b shows the acupunctureapplicator from the radiation side and the lens placed in this versionover the light sources 17, 17 a. The control mechanism can be programmedfor a randomised acupuncture programme with changing frequency,modulation and amplitude. This method can easily replace the well-knownMoxa method; Western doctors do not like Moxa treatment because of thesmell it produces, although it is very effective for treating chronicdiseases.

This form of light acupuncture is without any risk of infection as noneedles are used. It is completely pain free and the benefit can begreatly augmented by applying a topical light sensitive lotion beforeradiation (PDT). The radiation of trigger points and/or acupuncturepoints with strong light sources can cause pain, but by choosing lowfrequencies and intensities in the start phase and successivelyincreasing the frequency and intensity, the treatment is pain free andmore efficient.

FIG. 15 a shows a rectangular hand applicator with start-stop switchconnected to the control mechanism with a cable. FIG. 15 b shows anillustration of the hand applicator in side view, where the upper partis formed as a handle and the lower part is rounded for applicationdirectly onto the tissue to be treated, for example hair removal afterapplication of light sensitive substances (PDT-hair reduction). FIG. 15c depicts the hand applicator from the application side, where therectangular optic covers the printed circuit board mounted with multiplevarious selectable light sources 17, 17 a. The size and form make itvery suitable for hair reduction treatment where the radiation outletcan cover the whole area above the upper lip.

FIG. 16 a illustrates an applicator, connected with a cable to thecontrol mechanism, produced in the form of a quadrant tube, throughwhich the blood to be treated passes and receives radiation from allfour sides of the quadrant. FIG. 16 b shows how the inner sides areequipped with printed circuit boards with light sources 17, 17 a alsocontaining transmitter coils, radiating pulse-shaped electromagneticemission.

FIG. 16 c illustrates the blood tube designed for inner radiation roomin the applicator, through which the blood is passed during thetreatment. The illustrated version is designed for the radiation ofvenous blood, for example in combination with infusions of lightsensitive biopharmaceuticals (PDT therapy), but other applicator typesare also available for use in artificial heart/lung machines (notillustrated).

FIG. 17 a shows a large body applicator connected with a cable to thecontrol mechanism. The applicator is made of a lower and upper parthinged together and, in this illustration, shown closed, in an end view,ready for treatment.

FIG. 17 b is an illustration where the applicator is opened and theradiation surface shows the light sources available for therapy. Thismodel shows in the upper part every second light source as a standard UVlight tube, and in between, the flattened oval tubes containing thelight sources for the photodynamic therapy (PDT). The lower part isequipped only with the light tubes containing the light sources for thephotodynamic therapy (PDT).

FIG. 18 a illustrates one version of an emitter for the body applicator,shaped like an ordinary round light tube of standard length, 2.15meters, with a connector in each end for the supply.

FIG. 18 b shows how the printed circuit board equipped with the lightsources 17, 17 a placed in the round tube.

FIG. 18 c illustrates another version of an emitter for the bodyapplicator, preferably formed as a flattened oval tube in a standardlength of 2.15 meters and equipped with a standard connector in each endfor the supply. FIG. 18 d shows an end view of the tube with the printedcircuit board equipped with light sources 17, 17 a. The same printedcircuit board can also contain a transmitter coil for the emission ofpulse-shaped electromagnetic fields. The light tube is preferablymounted with a polarization 41 filter on the emitting side.

In the field of dermatology, light is used as a stand-alone therapy forwounds, leg ulcers, eczema, burns, etc., and as such is used tostimulate tissue directly. Light and the emission of pulse-shapedelectromagnetic fields may also be used to treat tissue usingphotodynamic therapy (PDT) by activating chemical reactions inphotosensitive chemicals introduced into or onto the tissue, such asphotofrin, 5-aminolevulan acid, hematoporphyrin, verteporfin, chlorins,phthalodyanines, phenothiazine, and benzoporphyrin-derivative monoacid-A(A TMPn) etc. for healing solar keratoses, basal cell carcinoma,melanomas, etc.

PDT substances may be administered in various forms: lotion or cream fortopical application, tablets or capsules for oral injection, and localinjection of solutions or infusion.

Dimethylsulfoxide (DMSO) is a solution, which has the property ofbreaking down the barrier of the skin and is often used beforeadministering PDT substances in order to increase the absorptionthereof. Alternatively, PDT substances may be mixed with DMSO forapplication to the skin.

An instrument consisting of a handle with a head, wherein a number ofneedles are connected to a spring arrangement, can be used to piercesmall, closely distanced holes in the upper layer of the skin before thePDT substances are applied, in order to increase and accelerate theabsorption.

Treatment by light irradiation with the invented device should notcommence until sufficient absorption by the target tissue is obtained.Simply waiting for empirically determined times to elapse can suffice,or photodynamic diagnostics (PD) may be employed to determineabsorption. PD comprises viewing the target area under illumination of aparticular spectral content (such as from a fluorescent light) andobserving apparent colour change of the target tissue.

High-intensity treatments (higher doses of PDT substances and strongirradiation) are used where it is desired to destroy tissue, as indestroying tumor tissue to cure cancer, or in hair removal where it isdesired to destroy the hair follicle. Low-intensity treatments are usedwhere it is desired to energize affected cells and to stimulate thelocal immune system, as in the rehabilitation of epicondylitis,tendinitis, arthritis, arthroses, gout, and pulmonary diseases; or inthe treatment of acne, actinic keratoses, warts, onychomycosis,psoriasis, dennatitis, and basal carcinoma; and in improving theappearance of wrinkles, cellulite, and fat deposits.

Low-intensity treatments have been observed to activate aspects of thelocal immune system such as the macrophages, which produce prostaglandinE2 (PGE2) and TNF (pro-inflammatory cytokines). There have also beenobserved an accumulation of leucocytes in the venules, and higheractivity of the lymphocytes and plasma cells in the skin. The residual 5content TNF-a of pro-inflammatory cytokines has been detected in theurine of patients after having PDT treatment.

Treatment with the invented device further enhances the efficacy ofmedicinal substances by photophoresis, a process of propelling fluidsinto the skin or tissue and propelling molecules through cell walls. Theabsorption process is accelerated, and the amount of PDT substanceabsorbed is increased. Other methods of phoresis are in use, such asgalvanic iontophoresis, exchange phoresis, and phono-phoresis. Thesemethods create a concentration gradient across the skin, and a resultantBrownian molecular motion creates a thermal influence which enhancestransfer of medicaments.

Photofrin is a PDT substance which is administered by injection, at adosage of 1-2 mg. per kg. of the patient's weight. 48 hours is allowedfor absorption of the photofrin by the tissue to be treated, duringwhich time the patient is kept in dim light The treatment consists ofirradiation by the invented device. The patient remains photosensitivefor 6 to 8 weeks, and should avoid strong light and direct sunlightduring that time.

ALA (5-Aminolavulinacid) is externally applied as a 10 to 20 percentmixture in an oil in water emulsion or in a cream. 4 to 6 hours isallowed for absorption, during which time the patient should remain indim light. After treatment by irradiation from the invented device, thepatient remains photosensitive for 24 to 48 hours, during which time heshould avoid strong light and direct sunlight.

L-Phenylalanin is applied in liquid form as a lotion or a spray or in acream form, in a 5 to 30 percent mixture according to the severity ofthe condition to be treated. Optical irradiation with the inventeddevice may begin almost immediately. Alternatively, doses of 50 to 100mg may be taken orally 30 to 60 minutes before irradiation. The patientis photosensitive for 24 hours after application.

PDT has been used successfully in the treatment of internal inoperablecancers. A biopharmaceutical (specifically, hematoporphyrin) is injectedinto the tumor tissue, and an optical method known as photodynamicdiagnostics (PD) is used to determine when the biopharmaceutical hasbeen absorbed by the entire tumor. Then the tumor tissue is irradiatedwith light typical for a dye laser, which activates the photosensitivereactors in the hematoporphyrin, whereby singlet oxygen is liberated.Singlet oxygen is toxic to protein and phosphor lipids in the tumortissue, whereby the tumor is destroyed without destroying thesurrounding tissue.

For treatment of skin keratosis (precancerous tissue), trials with, forexample, 5-aminolevulinic acid have shown that it can be usedeffectively in PDT if introduced into oil in a water suspension which isthen applied to skin keratosis and then irradiated with a light source.A fast and cosmetically perfect healing has been attained with a verylow rate of recurrence compared to conventional treatments, such ascryotherapy.

Common dermatological conditions, such as acne, warts, onychomycosis(nail fungus) and wrinkles, can be successfully and effectively treatedusing PDT (with ALA/5-aminolevulanic acid) at a lower concentration thanhas conventionally been used. The treatment works not by causing celldeath as light treatment has historically done, but instead works bystimulating the immune system so as to enable it to better control theinflammatory reaction to oil gland activity. The irradiation at multiplewavelengths as provided by the present invention enhances the efficacyof treatment in this manner.

Stimulating the immune system so as to reduce inflammatory reactions hasalso been found effective in the therapy of many other conditions, forexample, epicondylitis (tennis elbow), tendinitis, gout, arthritis,arthroses, pulmonary diseases, and numerous other muscular and jointsymptoms. Good results have been obtained with PDT in conjunction withthe present invention's multiple wavelength output. Studies indicatethat the patient often is pain-free after only one treatment, and thenumber of treatments can be reduced to 3-4, instead of 12-20 as requiredwithout the invented therapy.

The PDT substance is applied topically as cream or oil in watersuspension, typically a 10-20 percent solution. Augmented action may beobtained by use of injection instead of or in addition to topicalapplication. A large joint such as the knee requires 10-12 subcutaneousor intra-muscular injections, preferably at the trigger points, whilefor a smaller joint such as the elbow 5-6 injections is sufficient.First the trigger points are found and irradiated for 30 seconds withthe hand applicator of the present invention. This gives an anaestheticeffect, which is useful for lessening discomfort from the injections.(Injection of the trigger points is a known method for pain reduction).Then, after determination that the PDT substance has been absorbed bythe target tissue, the surface applicator of the present invention isfolded around the target joint and irradiation takes place for 30minutes.

Good results have also been obtained in physiotherapy and physicalrehabilitation with the present invention's ability to radiate visiblelight together with several wavelengths of infrared light andpulse-shaped electromagnetic radiation which, in combination, give amuch better effect in deep tissue affected by chronic disorders.

Thus, while the fundamental novel features of the invention have beenshown and described in this prototypic application, it should beunderstood that various omissions and substitutions and changes in theform and details of the devices illustrated, and in their operation, maybe made by those skilled in the art, without departing from the spiritof the invention. For example, it is expressly intended that allcombinations of those elements and/or method-steps that performsubstantially the same function in substantially the same way to achievethe same results are within the scope of the invention. Moreover, itshould be recognized that structures and/or elements and/or proceduresshown and/or described in connection with any disclosed form orembodiment of the invention may be incorporated in any other disclosedor described or suggested form or embodiment as a general matter ofdesign choice. It is the intention, therefore, to be limited only asindicated by the scope of the claims appended hereto.

The invention is intended for medical/dental invasive treatment,physiotherapy/rehabilitation therapy, dermatological and cosmetic skintreatment.

1. A device for photodynamic therapy (PDT), treating tissue andelectromagnetic field stimulation comprising: a stand; an adjustablemachine applicator connected to the stand through a jointed arm, whereinthe machine applicator contains a feedback sensor measuring at least oneof any temperature changes in the tissue being treated and lightreflected from the tissue being treated; a hand applicator connected tothe stand by an electric circuit, the hand applicator being adapted forthe application of light sensitive substances to human tissue, thetissue to be treated by at least one of air-pressure, iontophoresis andphotophoresis; a control mechanism adjustable from a control panel forcontrolling at least one of the adjustable machine applicator and thehand applicator; at least one light source supported by at least one ofthe adjustable machine applicator and the hand applicator and includingat least one of a semiconductor diode and a laser diode, the wavelengthof the light source being adjustable; a light conductor supported by atleast one of the adjustable machine applicator and the hand applicator;means for receiving light from at least one of the light sources;wherein the adjustable machine applicator comprises a scan engine formoving the at least one light source with linear movements;electromagnetic field transmitter coils supported by at least one of theadjustable machine applicator and the hand applicator, at least one ofthe frequency, length and amplitude of the electromagnetic field pulsesbeing adjustable; a photo diagnostic system (PD) supported by at leastone of the adjustable machine applicator and the hand applicator, andcontaining optics and a magnifier for photo diagnosis during thetreatment; and a power unit for providing operating power to the controlmechanism, wherein the at least one light source and the sensor arelocated on a printed circuit board.
 2. A device according to claim 1,wherein the light source contains at least two diodes.
 3. A deviceaccording to claim 2, wherein the two diodes emit light of differentwavelengths.
 4. A device according to claim 1, wherein the light sourcesare capable of being individually selected and switched ON or OFF.
 5. Adevice according to claim 1, wherein the electromagnetic fieldtransmitter coils are placed in the same printed circuit board on whichthe at least one light source is placed.
 6. A device according to claim1, wherein the stand is freely moveable on wheels.
 7. A device accordingto claim 1, wherein the machine applicator comprises several singleapplicators hinged together so as to be adjustable at angles withrespect to one another.
 8. A device according to claim 1, wherein themachine applicator contains sensors connected to the control mechanismfor measurement of reflected light for feedback control and automaticadjustment.
 9. A device according to claim 1, wherein at least one ofthe at least one light sources is mounted to the adjustable machineapplicator, and emits a fluorescent light for photo diagnosis.
 10. Adevice according to claim 1, wherein the hand applicator contains atleast one second light source connected to a pulse generator and atleast one light outlet.
 11. A device according to claim 10, wherein theat least one second light source comprises four selective light sourcesand a conductor for a light fiber cable.
 12. A device according to claim11, wherein the handpiece further comprises a circular printed circuitboard with the four selective light sources, said four selective lightsources comprising four different light sources, placed at 90°intervals; at least one light source emitting a fluorescent light forphoto diagnosis; and a head comprising a light conductor rotable in foursteps to selectively conduct light for photo diagnosis from the fourdifferent light sources to said at least one light outlet; wherein thecircuit board is mounted behind the rotatable head.
 13. A deviceaccording to claim 12, wherein a the light conductor includes a fibreoptic cable suitable for dental use for directing light to a desiredpart of the body of the patient undergoing treatment.
 14. A deviceaccording to claim 13, wherein the light conductor includes a flexibleoptic fibre cable for internal medical treatment.
 15. A device accordingto claim 14, wherein at least one of the adjustable machine applicatorand the hand applicator is formed as a rectangular tube containingadditional printed circuit boards with light sources placed at all fourinner walls for intensive radiation of a material which is locatedwithin the rectangular tube.
 16. A device according to claim 14, whereinthe machine applicator is adapted for whole body treatment and whereinthe machine applicator is disposed for movement to a position above abed on which a user undergoing treatment with the inventive device maylie.
 17. A device according to claim 10, wherein the hand applicator isequipped with a shaft and a head and a printed circuit board equippedwith semiconductor diodes.
 18. A device according to claim 10, whereinthe at least one light outlet is equipped with a lens and a polarizationfilter.
 19. A device according to claim 10, wherein the at least onelight outlet is equipped with at least one of a mounted lens and apolarization filter.
 20. A device according to claim 1, wherein the handapplicator is formed as a rectangle with a handle at the upper partequipped with a start/stop switch.
 21. A device according to claim 1,wherein at least one of the adjustable machine applicator and the handapplicator has a circular housing containing at least one of the atleast one light source equipped with a lens.
 22. A device according toclaim 21, wherein the circular housing is equipped with a self-adhesivepad for placement on the patient's skin when radiating acupuncturepoints.
 23. A device according to claim 1, further comprising: apressurized air-supply system connected by an air-supply tube to thehand applicator; and a chamber integrated in the hand applicatorcontaining the light-sensitive substances.
 24. A device according toclaim 23, wherein the air pressure is regulated and displayed on aninstrument.
 25. A device according to claim 23, wherein the air supplysystem provides air pulses to human tissue and wherein the length of theair pulses is regulated by means of a valve-system.
 26. A deviceaccording to claim 25, wherein the valve system is mechanical.
 27. Adevice according to claim 25, wherein the valve system is electrical.28. A device according to claim 25, wherein the switch system ismechanical.
 29. A device according to claim 25, wherein the switchsystem is electrical.
 30. A device according to claim 25, wherein thehand applicator contains a switch system to activate the treatment. 31.A device according to claim 30, wherein the hand applicator contains avalve by the air inlet.
 32. A device according to claim 31, where thehand applicator is exchangeable to suit the treatment area.
 33. A deviceaccording to claim 32, where the hand applicator is equipped with a skincontact sensor system to protect from excessive treatment.
 34. A deviceaccording to claim 33, wherein the hand applicator contains avalve-system which opens up automatically upon skin contact.
 35. Adevice according to claim 34, wherein the chamber containing the lightsensitive substances is integrated in the side of the hand applicator.36. A device according to claim 35, wherein the hand applicator containsa dosage pump for the light-sensitive substances.
 37. A device accordingto claim 36, where the hand applicator comprises a housing made of aninsulating material, and a treatment head, said treatment head beingmade of a conducting material.
 38. A device according to claim 37, wherethe hand applicator is connected to an iontophoresis generator in thecontrol mechanism for use as an iontophoresis electrode.
 39. A deviceaccording to claim 38, where the iontophoresis amplitude and frequencyis capable of being regulated by the control mechanism.
 40. A deviceaccording to claim 39, wherein the hand applicator contains at least onesecond light source connected to a pulse generator and at least onelight outlet.
 41. A device according to claim 40, wherein the handapplicator contains a second printed circuit board equipped withsemiconductor diodes and a feedback sensor.
 42. A device according toclaim 1, wherein the means for receiving includes an optic lens.
 43. Adevice according to claim 1, wherein the means for receiving includes apolarization filter.
 44. The device according to claim 1, in which theprinted circuit board is moved linearly.
 45. The device according toclaim 1, in which the printed circuit board is rotated.
 46. A deviceaccording to claim 1, wherein the adjustable machine applicatorcomprises a radiation outlet, and the device further comprises apolarization filter covering the radiation outlet.
 47. A method oftreating tissue, comprising the steps of: introducing a photosensitivesubstance to the tissue; determining when the tissue has absorbed apredetermined level of the photosensitive substance; and irradiating thetissue with a device according to claim
 19. 48. A method according toclaim 47, wherein the photosensitive substance is one of photofrin,5aminolevulan acid, hematoporphyrin, verteporfin, chlorins,phthaldodyanines, phenothiazine, benzoporphyrin-derivative mono acid-A(A TMPn), L-Phenylalanin.
 49. A method according to claim 47, whereinthe step of determining when the tissue has absorbed a predeterminedlevel of the photosensitive substance consists in observing that thetissue undergoes a predetermined colour change when viewed under apredetermined illumination.
 50. A method according to claim 49, whereinthe predetermined illumination consists of an optic system and afluorescent light source.